Diabetes Diagnosis Increases Psychiatric Disorder Risk

I understand that scientific studies must be completed so that it can become more than anecdotal evidence. These studies need to be published in reputable academic journals, showing the researchers have followed the proper protocols to get to the conclusion.

But for this latest study, I could have saved everyone a lot of time and money.

A large study in Sweden assessed children diagnosed with T1 diabetes and their healthy siblings over a longitudinal study (and also combined a comparison to the general population). Upshot? Here it is:

Children with type 1 diabetes are at high risk of psychiatric disorders, which seems to be a consequence of the disease rather than due to a common familial etiology. The results support recommendations on comprehensive mental health surveillance in children with type 1 diabetes, especially in recently diagnosed children.

In their research, the investigators found the risk for psychiatric morbidity tripled in the first six months of diagnosis. Even long-term, it was still twice as high for the entire observation period compared to the control subjects. I could have told them that.

No Surprise

For a child, a Type 1 diabetes diagnosis is traumatic. (Yes, it’s traumatic for the whole family. Let’s focus on the kid right now and what she/he thinks.) You go from being fine (or your concept of fine) to being told that you have an incurable disease that you can, at best, manage well enough to avoid major complications. Of course, you’ll have to be diligent, stab yourself with needles and lancets, and despite your best efforts, you may still get complications. You tell me if that would send you to your happy place…

I was diagnosed in 1983. Less than 24 hours after my Type 1 diabetes (it was called juvenile diabetes back then) was confirmed, I was in Joslin Clinic’s inpatient Diabetes Treatment Unit where I spent 11 days being indoctrinated. I was too busy learning about insulin and exchanges and sick day rules to really think about what the long-term impact on my life would be.

When it overwhelmed me, it wasn’t in the first six months. In my experience, my medical team and my family worked hard to prepare me for the long slog ahead to the best of their abilities. I know that I was loved and that I was educated in my disease. It took a year and a half, away from my family for an extended period of time on my own.

After the “novelty” of this diagnosis wore off, my head went to very dark places. I would have gone spelunking because I was a teenage girl, but diabetes gave me exclusive entry to depths that most kids don’t reach. Instead of crying over a crush, I was crying over a shortened life span and all those complications that everyone’s grandmother had. Guilt over blood sugars and A1Cs and feeling judged had me questioning my self-worth. My inability to get my blood glucose levels under control (thank you, puberty) for very long played a part in how I felt day-to-day. How the hell was I going to do this every day for the rest of my life?

We Can’t Do This Alone, But We Are Alone

I’ve never kept my bouts of depression a secret. It is liberating to talk about the things that scare you, as long as you know you feel safe. I have had some incredible medical professionals who have led me out of the dark places. I have some wonderful fellow T1 talkers who shine the light on the strong connection between T1 and depression. We can’t do this alone. It’s exhausting. And terrifying.

You can have the best cheerleaders on your team, but they’re not going to win the game for you. (That’s as close to a sports metaphor as you’ll get on this blog. Go team!)

Parents go through their own private hells when a child is diagnosed and I encourage any family to get counseling to talk through the tough times. (Think about the siblings who can become jealous because the T1 kid gets all the attention. I’m grateful that my brother wasn’t like that – at least that I know about.)

But in the end, it’s us. We are alone. The Type 1 child, no matter how protected, loved, educated, watched over… when we close our eyes at night, we think. And dream. And wonder. Sometimes, we travel to dark places. Some of us don’t want to come back. And that’s when it’s crucial that we have people who help us.

Researchers needed to do the studies to tell the medical community what we’ve been telling them for years. It’s not all in our heads.We are at risk simply because we have diabetes. We need a holistic medical team for every T1 child (and dare I say it, T1 adult): someone to teach us how to use insulin and count carbs and someone to teach us how to live our lives with diabetes in a healthy way – body and mind.

If you (or someone you know with Type 1 diabetes, especially those who are newly diagnosed) need help, please… talk with your medical team about your thoughts. There are options and support groups and professionals… For your children who have been diagnosed, please understand that no matter how much love you show them, they may need outside help that you can’t give. That’s OK. Really, it is.

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Terrific Post. Thank You. When I was diagnosed in 1969 at age 15 I put together a list of 25 ways I could commit suicide. Then I managed one day and then the next and the next and now it is 46 years later. Although there are so many more options today, the pressure to be perfect is overwhelming. It is easy to understand how children diagnosed with Type 1 go to dark places and feel like “damaged merchandise.” That was and on some days still is my desciprtion of how I felt.

Hi Arlene – you are the first person I’ve read who was diagnosed the same year and age that I was. I knew there where others of course, but I never met any of them. I still don’t have any friends who went through what I did. Anyway – nice to know you’re out there. Take care

Thank you so much for sharing this. I was diagnosed as an adult and it’s been tough enough for me. I hope everyone who needs help seeks it. Perhaps if we do, we make it easier for the next person to do so too.

This is so true. I’m beginning to think that if one has diabetes,& (seemingly)doesn’t have any mental health issues they are the exception,rather then the rule. And still,nobody(D team) is talking about it,until you maybe end up in the ICU a few years after dx with DKA of unexplained causes when it’s like hey,are you possibly suicidal? Yep. Ok, here are some support resources. They need to do a much better job at screening for depression,rather then do damage control later.(sometimes too late)

Katy, This just isn’t talked about enough. There is a preoccupation with numbers and labs and getting the right insulin dose and a severe lack of ongoing psychological support for T1s as they come to grips with this. The more I’ve thought about it, the angrier and more distraught I get. (A healthy anger. A sincere distress. Good will come from both.)